Sec. 723. Payment adjustments for outpatient services for certain children's hospitals
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/bill/119/hr/3838/eh/section-723·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1079(i) of title 10, United States Code, is amended— by redesignating paragraph
(4)as paragraph (5); and by inserting after paragraph
(3)the following new paragraph (4): In addition to amounts paid under paragraph (2), the Secretary shall pay an annual payment adjustment to a children’s hospital for outpatient services if the Secretary determines that, with respect to the year covered by the payment adjustment, the hospital meets one or more of the following criteria: 10 percent or more of the revenue of the hospital comes from services provided to covered individuals under the TRICARE program. The hospital received not fewer than 10,000 visits by covered individuals that were paid under paragraph (2). The hospital has been determined by the Secretary to be essential for operations of the TRICARE program. The amount of the annual payment adjustment paid to a children’s hospital under subparagraph
(A)shall be the amount that is 30 percent of payments made under the Outpatient Prospective Payment System (or successor system) to the children’s hospital under paragraph
(2)during the year covered by the annual payment adjustment for outpatient services provided to covered individuals. In this paragraph: The term children’s hospital means a provider of services provided under a plan covered by this section that is a children’s hospital. The term covered individual means a member of the armed forces serving on active duty or a dependent of such a member. . The Secretary of Defense shall— develop a payment methodology to determine the amounts required to be paid under paragraph
(4)of section 1079(i) of title 10, United States Code, as added by subsection (a); and prescribe joint regulations to carry out such payments that are separate from the regulations concerning outpatient prospective payments pursuant to paragraph
(2)of such section.